Le syndrome confusionnel en gériatrie, Enseignement, Oct 2020.

Bérengère et Éric Maeker le 30 Octobre 2020.

Le syndrome confusionnel est une problématique courante en gériatrie dont il est indispensable de connaître les contours pour les internes (médecine générale, urgences et gériatrie), les jeunes médecins et les soignants de gériatrie.

Cet page référence une vidéo d'enseignement et des documents utiles à la pratique gériatrique.
Avertissement et conseil : La vidéo est dense. Nous avons essayé de tenir le format d'une heure. Vous pouvez à tout moment, mettre en pause, passer un chapitre, ré-écouter un chapitre, etc. Libérez-vous des contraintes du linéaire !
Chrono Partie Sous-partie
00:00 Début de la vidéo
00:24 Présentation de la carte + liens
00:42 Définition
01:38 DSM5
04:39 Présentation clinique
05:22 Histoire de la maladie
10:08 Signes cardinaux
13:25 Signes associés
17:13 Examen clinique
19:06 Outils cliniques de détection
20:12 CAM-4
24:26 Diagnostics différentiels
27:18 Étiologies
27:57 COVID-19
29:40 Facteurs de risque
33:37 Diagnostic paraclinique
35:13 Paramètres vitaux
35:59 Examens de première ligne
37:46 Examens de seconde ligne
41:21 Évolution, complications, pronostic
45:07 Modalités de prise en charge
45:21 Prévention
46:43 Diagnostics d'urgence
47:14 Réorientation
47:43 Mobilité
48:24 Cycle nycthéméral
49:15 Traitement médicamenteux
52:55 Prise en charge pour les soignants
52:58 Place de la contention physique passive
54:04 Attitudes à favoriser
55:31 Attitudes à éviter
56:19 Surveillance paramédicale
58:35 Conclusion
1:02:40 Trouvez la blague… PS : y en a aussi dans toute la vidéo…

syndrome_confusionnel_2020_map.pdf

Et comme pour l'ensemble de ce site d'ailleurs.

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  • HAS, Confusion aiguë chez la personne âgée : prise en charge initiale de l'agitation, 2009. Lien

La bibliographie présentée sur cette page renvoie aux méta-analyses et revues systématiques concernant la partie de l'évaluation gériatrique 1)2)3).

Aidants 4)

Biométrie et autonomie 5)6)

Fragilité et comorbidités 7)8)

Escarres 9)10)

Douleur

Soins palliatifs 11)

Psychogériatrie 12)13)14)

Thérapeutiques

Chutes 15)



1) Ellis G, Gardner M, Tsiachristas A, Langhorne P, Burke O, Harwood RH, Conroy SP, Kircher T, Somme D, Saltvedt I, Wald H, O'Neill D, Robinson D, Shepperd S. Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev. 2017 Sep 12;9(9):CD006211. doi: 10.1002/14651858.CD006211.pub3. PMID: 28898390 PMCID: 6484374
2) Puts MTE, Santos B, Hardt J, Monette J, Girre V, Atenafu EG, Springall E, Alibhai SMH. An update on a systematic review of the use of geriatric assessment for older adults in oncology. Ann Oncol. 2014 Feb;25(2):307-15. doi: 10.1093/annonc/mdt386. Epub 2013 Nov 19. PMID: 24256847
3) Kuo H, Scandrett KG, Dave J, Mitchell SL. The influence of outpatient comprehensive geriatric assessment on survival: a meta-analysis. Arch Gerontol Geriatr. 2004 Nov-Dec;39(3):245-54. doi: 10.1016/j.archger.2004.03.009. PMID: 15381343
4) Armstrong NM, Gitlin LN, Parisi JM, Roth DL, Gross AL. Association of physical functioning of persons with dementia with caregiver burden and depression in dementia caregivers: an integrative data analysis. Aging Ment Health. 2019 May;23(5):587-594. doi: 10.1080/13607863.2018.1441263. Epub 2018 Feb 22. PMID: 29469590 PMCID: 6172154
5) Martyr A, Clare L. Executive function and activities of daily living in Alzheimer's disease: a correlational meta-analysis. Dement Geriatr Cogn Disord. 2012;33(2-3):189-203. doi: 10.1159/000338233. Epub 2012 May 10. PMID: 22572810
6) Cipriani G, Danti S, Picchi L, Nuti A, Fiorino MD. Daily functioning and dementia. Dement Neuropsychol. 2020 Apr-Jun;14(2):93-102. doi: 10.1590/1980-57642020dn14-020001. PMID: 32595877 PMCID: 7304278
7) Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Mark Clarfield A. The identification of frailty: a systematic literature review. J Am Geriatr Soc. 2011 Nov;59(11):2129-38. doi: 10.1111/j.1532-5415.2011.03597.x. Epub 2011 Sep 21. PMID: 22091630
8) Apóstolo J, Cooke R, Bobrowicz-Campos E, Santana S, Marcucci M, Cano A, Vollenbroek-Hutten M, Germini F, Holland C. Predicting risk and outcomes for frail older adults: an umbrella review of frailty screening tools. JBI Database System Rev Implement Rep. 2017 Apr;15(4):1154-1208. doi: 10.11124/JBISRIR-2016-003018. PMID: 28398987 PMCID: 5457829
9) Pancorbo-Hidalgo PL, Garcia-Fernandez FP, Lopez-Medina IM, Alvarez-Nieto C. Risk assessment scales for pressure ulcer prevention: a systematic review. J Adv Nurs. 2006 Apr;54(1):94-110. doi: 10.1111/j.1365-2648.2006.03794.x. PMID: 16553695
10) Kim G, Park M, Kim K. The Effect of Pressure Injury Training for Nurses: A Systematic Review and Meta-analysis. Adv Skin Wound Care. 2020 Mar;33(3):1-11. doi: 10.1097/01.ASW.0000653164.21235.27. PMID: 32058443
11) Krooupa A, Vivat B, McKeever S, Marcus E, Sawyer J, Stone P. Identification and evaluation of observational measures for the assessment and/or monitoring of level of consciousness in adult palliative care patients: A systematic review for I-CAN-CARE. Palliat Med. 2020 Jan;34(1):83-113. doi: 10.1177/0269216319871666. Epub 2019 Aug 22. PMID: 31434526 PMCID: 6952953
12) Krishnamoorthy Y, Rajaa S, Rehman T. Diagnostic accuracy of various forms of geriatric depression scale for screening of depression among older adults: Systematic review and meta-analysis. Arch Gerontol Geriatr. 2020 Mar-Apr;87:104002. doi: 10.1016/j.archger.2019.104002. Epub 2019 Dec 19. PMID: 31881393
13) van Velthuijsen EL, Zwakhalen SMG, Warnier RMJ, Mulder WJ, Verhey FRJ, Kempen GIJM. Psychometric properties and feasibility of instruments for the detection of delirium in older hospitalized patients: a systematic review. Int J Geriatr Psychiatry. 2016 Sep;31(9):974-89. doi: 10.1002/gps.4441. Epub 2016 Feb 21. PMID: 26898375
14) Tsoi KKF, Chan JYC, Hirai HW, Wong SYS, Kwok TCY. Cognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis. JAMA Intern Med. 2015 Sep;175(9):1450-8. doi: 10.1001/jamainternmed.2015.2152. PMID: 26052687
15) Soubra R, Chkeir A, Novella J. A Systematic Review of Thirty-One Assessment Tests to Evaluate Mobility in Older Adults. Biomed Res Int. 2019 Jun 20;2019:1354362. doi: 10.1155/2019/1354362. eCollection 2019. PMID: 31321227 PMCID: 6610744

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